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The family of a woman immobilized by Alzheimer's disease is considering an appeal to the Supreme Court of Canada, after British Columbia's highest court dismissed their attempt to bar care-home employees from feeding her by spoon.
Margot Bentley has not spoken since 2010. The 83-year-old is in the final stage of Alzheimer's and does not appear to recognize family members, or anyone else. She spends her days slumped in a chair or bed with her eyes closed, according to court documents.
Ms. Bentley has been at Maplewood House, a care home in Abbotsford, B.C., since 2009. Care-home staff wake, dress and feed her.
Her daughter and husband have argued she signed a "statement of wishes" – or living will – that said she should be allowed to die if she suffered from an extreme disability with no expectation of recovery. They said the document, signed in 1991, stated she should not be provided with nourishment or liquids in such a scenario. The family has said the care home is spoon-feeding Ms. Bentley without her consent, which constitutes battery.
A B.C. Supreme Court judge decided against the family last year, ruling the statement of wishes – and another unsigned, undated living will that was discovered by Ms. Bentley's husband in 2011 – were unclear. The judge said Ms. Bentley was capable of making the decision to open her mouth and be fed, and the spoon-feeding constituted personal care rather than health care.
The family had hoped the decision would be overturned, but its application was dismissed Tuesday by the B.C. Court of Appeal. The court said the trial judge did not err when he inferred Ms. Bentley wanted to be fed, or in his rejection of the claim of battery.
Katherine Hammond, Ms. Bentley's daughter, said she was disappointed but not surprised by the ruling. In an interview, she said the family will further review the judgment before determining whether to seek leave to appeal to the Supreme Court of Canada. She said words cannot describe how "horribly depleted" her mother has become 16 years into her fight with Alzheimer's.
"She wrote her directives and spoke to us about them many, many years ago, when she was of sound mind and body," Ms. Hammond said. "We have to respect that. This person who she has become is not who she was when she wrote her living will."
Kieran Bridge, the lawyer for the family, said the issue of consent and how it applies in such a situation did not appear to be fully addressed by the appeal court and could be suitable for the Supreme Court of Canada.
"The primary issue is whether someone can be taken to have consented to something, when before the alleged battery takes place there has been no consent given," he said in an interview.
Dale Strebchuk, the lawyer representing Maplewood Seniors Care Society, said he believed the appeal court's decision was well-reasoned. The society's chief executive officer did not return a message seeking comment.
Ms. Bentley previously worked as a nurse. Her family has said she saw how Alzheimer's could leave patients unresponsive and did not want the same thing to happen to her.
Justice Bruce Greyell, the trial judge, ruled Ms. Bentley was not dying but depriving her of nourishment and water would have that effect. He said Ms. Bentley's family did not prove that she was opening her mouth to be spoon-fed purely as a reflex.
Legal experts at the time said the case should prompt people to take a closer look at their living wills.
Ms. Hammond, who like her mother became a nurse, reiterated that message Tuesday: "I'm hopeful that people will really start thinking about their own end-of-life [plans]."
The three-judge appeal court panel was unanimous in its ruling, which was written by Justice Mary Newbury.
The judgment said the court recognizes the "terribly difficult situation" in which Ms. Bentley's family finds itself and appreciates "the disappointment they must feel in being unable to comply with what they believe to have been her wishes."
But the judgment said the court must ascertain a patient's wishes in the here and now.
It said the principle of patient autonomy and "clear consent" has been reflected in many judicial decisions, including the recent Supreme Court of Canada ruling on physician-assisted suicide.